Thursday, October 27, 2011

treehugger

Every nurse encounters poop. Like, lots of poop. And this, friends, is a poop story.

Pt. was admitted to the Medical ICU for a series of TIA's; he had already suffered multiple strokes before this admission, and resided in an assisted living home. He was not as well tended as he should have been there, and that trend followed him here. I normally work in the CVU, but because our unit was short on patients ("low census," for the uninitiated), I "floated" to MICU and took care of Patient. I took him from Odessa, another CVU nurse, who had received him from Jimmy, my partner in crime. In his entire admission, he had not once been cared for by any of the native nurses. My guess is that the charge nurse, Heidi, didn't think we were up to the usual medical disasters present on the MICU (her words to me: "Well, we don't want to give you anything too hard." Wow, you're right, I'm probably stupid. Fuck you too, lady.) Hence, Patient was being handed to the floats because he wasn't challenging or sexy enough. Whatever. For once, I knew I would get a lunch.

We had a good day, and yes, it was easy to care for him; I felt badly for the regular staff on the unit because they were working unbelievably hard compared to what I was doing. Toward the end of the shift, I received news that Patient was being returned to his facility. I went in to share the news with him that everyone thought he was stable enough to go home. Before I got a single word out, he stared at me dolefully and moaned, "You know, my stomach is just killing me." I immediately stopped and gave his belly a listen, then pushed on it a bit...damn. It was kind of firm, more so than when I had assessed him previously. I asked him if he felt like he needed to poop, and if he had been passing gas lately. He was bed-bound, so I wasn't too surprised that no one knew the last time the poor bastard had gotten the pleasure of unloading.

I took a deep breath. Of course, it was 1800, and I was supposed to be preparing his transfer paperwork. But damn it, a man's gotta move the mail sometimes. Apparently, 1800 with transport en route was that time.

I explained disimpaction to him. He didn't care, he just said "please, just help me."

Gloves. A heavy duty chuck (which is a really absorbent pad...sort of a "pee pee pad" for people). Wipes. Surgilube. A garbage can. It was on.

I asked him to try one more time to push on his own. I may be the Brown Queen, but that doesn't mean I want to wedge my fingers in anyone's ass. He was unsuccessful, grunting and sweating and groaning all the way.

GO TIME!

I started working on the dry matter. Some poop made its way. Then...he started pushing again.

We had busted the dam.

I had never seen anything like it, and I haven't since. It was HUGE. The size of a small baby. I am not exaggerating. I was immediately angry that no one at his home had even noticed that he hadn't notably crapped recently, but relieved I caught it...so to speak. Technically, it had actually landed on the chuck. At least there was no cord to cut.

Another nurse had noticed at this point that I hadn't been out of the room for a while and came to check on me. Her head popped around the privacy curtain. "Are you okay in here?", she asked. "Yeah, I'm fine, but I could use a hand getting my friend here cleaned up." My voice was calm, but I was jerking my head back to urge her to LOOKIT THIS GIANT DOOKER, OMG. She came around the bed to where I was, frowning...and then she saw. Her eyes got big, but in her best nursing voice: "Sure, I'd love to help you. Are you doing all right, sir?"

Honestly, we sound like airline stewardesses in turbulence.
More coffee? SkyMall magazine? A bit of the Finger?
It's just a little turbulence. We only dropped a few dozen feet.
You only shit a cinder block. It's fine now.

God. Patient was so happy. I'd swear his grips even improved on his weaker, affected side. He said "thank you so much" at least four times in the time it took me to clean up and wash my hands.

After we got Patient situated, did I do my paperwork? Did I call report to his home? Nope. I texted Jimmy.

"didn't you have the guy in room X yest?"
"yep, why? is he ok?"
"i just disimpacted him", then
"omfg, it was like a sequoia log"

I am EveryNurse.

Like nurses everywhere, I have a love-hate-wth?? relationship with my profession and its trappings. This is a forum free of HIPAA Nazis; a no-Human Resources, CMS-less, JCAHO-resistant zone for me---us---to vent. You know what that means? That's right---you get to bring coffee and snacks to this blog.

Also, I don't want to do all the work myself.

Do you think very deeply? Got an axe to grind? Story to share that's so damn strange it has to be true? If you are somehow involved in or employed by a health care institution, I'm all about a guest blogger. I mean, shit, even "Columbo" had an episode with Very Special Guest Star Johnny Cash one week.